Published in IIPS Mumbai, ENVIS center, Volume 2, No. 3, September 2005

 

Prevention of Diarrhoeal Disease in

Migrant Households in Delhi

Dr. Rajib Dasgupta*

INTRODUCTION

 

Diarrhoeal disease is a water borne Disease having high prevalence in the age group of 0-4 Population. Research study carried out by Chakraborty and Das (1983) shows incidence of diarrhoea among children belonging to low families with poor socio-economic status in two different environmental situations in Calcutta –living in slums and non slums in Calcutta Metropolitan Development Authority (CMDA). It has been observed that diarrhoea episode per child was 1.6 in slums and 1.4 in CMDA area; there was no significant difference. Incidence was high among infants in both the groups but declined sharply in CMDA children at 2 years. Provision of running water and sanitary latrines (as common facilities and not at the household level) in CMDA project areas did not reduce diarrhoea to any significant extent as compared to the slum children.

 

Ghosh et al (1997) have, through community based studies, explored the risk behavioural practices of mothers of families residing in slums in Calcutta and Varanasi and in rural areas in Haryana and Hyderabad. He observed that a sizeable proportion of children did not suffer from diarrhoea though they lived in the same area as that of the children with diarrhoea. In Calcutta slums, 53.4% of children remained diarrhoea-free during the one year study period with six days a week of active

 

surveillance.2 Risk factors attributed to mothers showing significant association with presence of a child with diarrhoea in the family included use of pond water for cleaning child-feeding containers, indiscriminate disposal of children’s stools, bottle feeding, non-use of soap for cleaning child-feeding containers and water storage in a wide mouthed container.

 

The transmission routes of the etiological pathogens for diarrhoea are complex. Briscoe (1984a) pointed out the importance of evaluating multiple routes of transmission and assessing the impact of an individual determinant. While recognising that generally speaking, the risk of  infection increases exponentially with the dose (of pathogens), it ought to be remembered that transmission can take place through several routes and water, food and person-to-person transmission are the most critical variables for faecal-oral contamination leading to diarrhoeal disease. 

 

Historically, improvements in the microbiological quality of drinking water have played a central role in the reduction of morbidity and mortality from diarrhoeal diseases (including cholera), particularly in Europe and North America in the nineteenth century. Microbiological data collected in a detailed clinical case study of cholera in Matlab, Bangladesh have focussed on each of the possible different transmission routes and had concluded that most of the transmission was through drinking water. However, on account of the existence of secondary transmission routes such as ingestion of contaminated water during bathing and also because the dose-response relationship was approximately log-linear, elimination of the main route did not get reflected directly through major reductions in the incidence of diarrhoea.

 

The debate continues on the most appropriate intervention for reduction of diarrhoeal illnesses, particularly in the deprived segments of urban communities. Arguments continue on whether the decisive factors are engineering/infrastructural and socio-economic/behavioural. While it is imperative to provide households with adequate, safe and reliable water supply and sanitation services, household behaviour and resources and preferences of households also form critical determinants of diarrhoeal diseases. In the ultimate analysis, all these factors are highly intertwined. These include water sources, interruptions in piped supplies, water storage practices and water quality of both sources and on storage. The household’s access to a sanitary latrine must also be taken into account.

 

 

 

 

 

 

 

PROBLEM

Our hypothesis is that behavioral factors at the individual household level loose their significance as major determinants of diarrhoeal diseases once they are analyzed in a more comprehensive and holistic social epidemiology frame that takes into account factors such as poverty, provision of services, living conditions and settlement patterns.

 

THE STUDY DESIGN

The determinants at the household level are explored through a dataset based on a primary survey of 300 households in Delhi. The study was conducted in 300 households in three selected clusters in Shahdara (North) and Shahdara (South) Zones of the Municipal Corporation of Delhi that are known to be endemic for diarrhoeal diseases.

 

 

Diarrhoea Definition: Diarrhoea is defined as the passage of loose, liquid or watery stools. These liquid stools are passed more than three times a day. It is to be emphasised that recent changes in consistency and character of stools are more important than the number of stools. When blood is visible in watery stools, the condition is defined as dysentery.  Measurement: Incidence rate is defined as “the number of new cases occurring in a defined population during a specific period of time” (Park, 2000). It is calculated by the formula:

 

Number of new cases of a specific disease during a given period

                  ---------------------------------------------------------------------------------------------------------         x1000

 Population at risk during that period

 

The incidence rates were calculated for a recall period of two weeks for the general population and children under five years of age. The associations between household level vulnerability factors and incidence of diarrhoea were examined through assessing distribution of incidence over different types of households.  

 

For the cross-sectional study, water samples were tested from the main sources accessed, and, storage containers in the household. A two stage sampling was conducted.  In the first round, all the community sources were tested.  Based on the results, household stored samples were lifted to test for the extent of contamination at the domestic level.  If a certain source failed the test, water samples were not tested for households storing drinking water from that source.  Only households storing water from sources that had passed the initial screening test were further sampled.

 

For purposes of sampling, a total of 60 water samples were collected i.e. 20% of the 300 households that were surveyed.This ensured that epidemologically sensitive results were obtained for deriving conclusions about the exposure to contamination through the water mat was being accessed by these 300 households.

 

RESULTS Incidence of  Diarrhoea

The household factors for vulnerability to diarrhoeal diseases were studied in further detail in 100 households each in the following clusters :

  • Sanjay Amar Colony, JJ Cluster, Shahdara (South) Zone (refered hearafter as Cluster 1)

  • Taj Colony, JJ Cluster, Shahdara (North) Zone (referred hereafter as Cluster 2)

  • Welcome Colony, Double Storey, Resettlement Colony, Shahdara (North) Zone (referred hereafter as Cluster 3).

 

 

 

 

 

 

Box 2: Testing procedure of water sample

Bacteriological tests for water quality surveillance include the following tests:

 

Presumptive coliform test (most commonly performed), Tests for detection of faecal streptococci and Clostridium perfringens, Colony count.The  presumptive coliform test is the most  relevant one for purposes of the present study  and is described below in detail. This test is based on the most probable number (MPN) of conform organisms in 100 ml of  water. The test is carried out by Inoculating measured quantities of the sample water -0.1,1.0,10 and 50 ml into tubes of McConkey’s Lactose Bile Salt Broth with Bromcresol Purple as Indicator. The tubes are incubated for 48  hours.  From the number of tubes showing acid and gas, an estimate of the MPN of coliform organisms in 100 ml of the sample can be obtained from standard tables. This result is known as the ‘presumptive coliform count’, the presumption being each tube showing fermentation contains coliform organisms. The reaction may  however occasonally be due to the presence of some other organisms or combination of organisms. Based on the guidelines for drinking water quality recommended by the WHO in 1996, the ISO (IS10500)  prescribe that the coliform count of a drinking water sample should be less than or equal to 10 per100 ml of water. The WHO recommendation for drinking water quality lays down the primary standards as prescribed limits that must never be exceeded in water meant for drinking  purposes. 

 

The term water source was defined with reference to the means by which water was accessed.  The means of access play the most important role in influencing as well as indicating the quality of water being consumed by a particular household.  The word ‘source’ therefore was used to characterise water available at the point of access throughout the study. Points of access has similar characteristics and implications for water contamination, were clubbed together and labelled as a particular source. Thus, for example, shallow handpumps was one source, as distinguished from deep bore tubewells which was considered to be another distinct source.

 

It is important to understand that the Clusters 1 and 2 are among the most vulnerable clusters having migrant population and that the study was conducted during the most critical months from the point of view of diarrhoeal diseases. The incidence rates of diarrhoea for a two week recall period was computed and is reported in Table 1 below. The number of diarrhoea cases reported in the survey is relatively small and therefore generalisations based on the analysis have to be made with caution. Table 1: Incidence Rate (per 1000) of Diarrhoea in the Three Clusters

 

 

Cluster 1

Cluster 2

Cluster 3

 

All

<5

All

<5

All

<5

 

age

chil

age

chil

age

chil

 

s

dre

s

dren

s

dren

 

 

n

 

 

 

 

No.of Cases

42

38

28

21

39

25

Incide

78.7

157

48.0

216.

18.8

71.4

nce

 

.8

 

2

 

 

Rate

 

 

 

 

 

 

 

For all age groups and recall periods the Incidence rates are highest in Cluster 1, Intermediate In Cluster 2 and lowest in Cluster 3, except for incidence rate for under-5 children with a recall period of two weeks, which is highest in Cluster 2.  

 

Analysing the Incedence rate of diarrhoea among different income groups in these clusters it is observed that diarrhoea incidence rates are highest for Cluster 1 by income categories, except for the family income category of Rs. 1501-2000 per month. Within the cluster there are no unidirectional associations between incidence rates and income levels. This holds true for all three clusters.

 

DETERMINANTS OF VULNERABILITY

 The correlation coefficient between family income and educational level of head of household is not significant for any of the clusters at the 5% level.  The correlation coefficient is marginally higher at 0.06 for Cluster 1 as compared to 0.03 for the other two Clusters.

In general, across clusters, MCD piped supplies was the primary water source. However, there are exceptions to the pattern within clusters across income groups. The residents of Cluster 1 in all income categories, accessed MCD piped supply as the primary water source; the public hydrants were distributed in a fairly even manner within the slum cluster. 

 

 In Cluster 2 the poorer households were located farthest from the public hydrants which were located near the road. As a result, 80% of the poorest households reported handpumps as the primary source of water.

 

 

 

 

 
 

In Cluster 3, the ownership of individual hand pumps and tube wells that were used as additional water sources were in the higher income groups. Some of the hand pumps in Clusters 1 and 2 were installed by the civic authorities. However, groups of families with higher incomes also pooled resources to installed shallow hand pumps

 

 For augmenting water supply. In all the three clusters, the data reveals a positive association between households with an additional source of water and increasing income levels, particularly with regard to the middle income ranges across clusters.

 

In Cluster 1, 90% of those with lowest family incomes accessed the community sanitary latrines. This dropped to an average of about 60% for the higher income levels. In Cluster 2 there are no provisions for community sanitary latrines. Also, there is no scope for construction of individual latrines, irrespective of the income level. The dwelling units in Cluster 3 were constructed with individual sanitary latrines. Thus it is obvious that, in the chosen clusters, colony level factors are critical rather than individual income levels in determining access to sanitary latrines, community or individual.

 

11% of the households reported using hand pump water for drinking purposes In Cluster 1. Among these families, 73% of heads of household and 89% of mothers were illiterate. With improvement in educational status of both, use of hand pump water for drinking reduced significantly. The trend was similar in Cluster 2 as  well. The trend was different in Cluster 3.Ten percent of head of households using tube well water and 66.67% of those using hand pump water for drinking purposes belonged to the higher education group; they were also households reporting high incomes. But among mothers belonging to the higher education group 87.5% were using MCD water for drinking. As educational status of mothers declined, consumption of hand pump water of drinking increased significantly.

 

In Cluster 1, the water sources were only shallow hand pumps and public hydrants. The distribution of these community sources were 3 shallow hand pumps and 6 public hydrants. Water samples were collected from all these sources since these were the only sources possible contamination with counts of 2400 each. The public hydrants, all 6 passed the test with the best possible quality- a count of 0 each.

 

Like Cluster 1, the water sources were only shallow hand pumps and public hydrants in Cluster 2. The distribution of these community sources were 8 shallow hand pumps and 4 public hydrants.  Water samples were collected from all these sources since these were the only sources accessed by all the households in these clusters.  The hand pumps, all 8, were found unfit. The MPN counts ranged from a minimum of 75 to a maximum of 2400. The public hydrants, all 4, passed the test with MPN counts ranging from 0 to 4.9.

 

In Cluster 3, there were households using water from tube wells as the source of drinking water.  Samples were taken  from both these tube wells. One tube well was found to be fit (MPN count 3.1) while the other was found to be unfit (MPN count 13).

The MCD pipelines supplying these Oats entered the colony from two sides. Two samples were taken, one from each side. The rationale was that the supply made available should be evaluated on the basis of the quality of water In the main pipelines as the responsibility of the provider is only up to this level only.  Beyond these points the maintenance of the service pipelines are the responsibility of the consumers (resident). All the MCD samples tested fit. There were 19 households drinking water from shallow hand pumps. These were all individually owned hand pumps in contrast to commonly hand pumps in the other two clusters. All these hand pumps tested unfit for drinking purposes.  

 

Table 2: The laboratory test results are summarized.

Note: All figures are in percentages. F: Fit; U: Unfit; NA: Not applicable.

 

 

 

 

 

 

For analyzing the relevance of storage practices with regard to diarrhoeal incidence rates households were classified on the basis of the source of drinking water accessed by them, MCD and non-MCD. For households that stored water drawn from MCD sources, data was analyzed with reference to the storage practices. For purposes of comparison, Incidence rates of diarrhoea were also computed for households mat accessed MCD sources but did not store.  Incidence rates were also computed for the remaining set of households, namely, those that accessed non-MCD sources. Since bacteriological tests revealed (Table 2),that MCD sources (Public hydrant and household) were 100% fit, in order to isolate the effect of storage practices, from MCD sources have been considered for the analysis. Table 2 presents the results from the analysis. The impact of use of separate utensil to draw water from the storage containers is relevant only in case of those households that stored water in wide mouthed containers. Table 3 reports the findings.

 Epidemiological logic suggests that incidence rates for diarrhoea among households with best storage practices should be the lowest, provided other factors are comparable. In the context of the present dataset, best storage practice would correspond to households which store water in covered vessels with narrow mouths. Use of separate utensil to draw out water from the storage container also

Table 3: Storage PraoBcesm (the three clusters)

 

 

MCD Sources

Non--MCD

Cluster 1

Covered Vessel wide mouth

Covered Vessel Narrow mouth

Uncovered Vessel wide mouth

UNcovered Vessel Narrow mouth

Not stored

No.of H.H

37

39

6

6

1

11

I. R

63.8(12)

107.9(23)

68.9(2)

64.5(2)

0(0)

44.1(3)

Cluster 2

 

 

No.of H.H

15

12

21

-

3

49

I. R

70.4(5)

27.0(2)

53.4(7)

-

62.5(1)

44.7(1-3)

Cluster 3

 

 

No.of H.H

38

36

2

3

-

21

I. R

65.4(11)

104.3(17)

0.0(0)

47.6(1)

-

66.2(1-0)

 

Note : IR: Incidence Rate, HH: Households.

constitutes best practice. However, there are variations in the sources from where water is drawn for storage, and this implies variations in the quality of water being stored by households as demonstrated earlier through the laboratory results. 

  In Clusters 1 and 3, the highest incidence rate for diarrhoea is observed in the best practice category while for Cluster 2, the expected results are obtained. These findings prompt further exploration of the vulnerability factors underlying the apparent paradox. Analytically, a standard starting point is to explore differences in diarrhoeal incidence rates by age. In analyzing the findings obtained, a distinction was made between children under-5 (U-5) years and those in the age group of 5-18 years. It is hypothesized that U-5 children who stay at home, particularly where the proportion of working mothers is low, are likely to be under better supervision and therefore have lower incidence of diarrhoea. In contrast, children going to school are more likely to consume unsafe water and drinks outside the home.

It is observed that the proportion of U-5 children in the best practice category of households was lower in Cluster 1 as compared to the other storage categories; diarrhoea incidence was higher among the 5-18 years age group in the best practice category. In Cluster 2, this pattern is reversed with there being a higher proportion of U-5 children and a lower incidence of diarrhoea among children in the 5-18 years age group in the best practice households as compared to the other storage category households. In Cluster 3, the pattern of Cluster 1 is observed with a lower proportion of U-5 and higher incidence of diarrhoea in the 5-18 years age group for the best practice households.

 

 

 

 

 

 

These findings prompt a further exploration of children in the school going age, that is, 5 to 18 years. The proportion of children attending school was computed for each cluster. It was found that in Cluster 1, 64.2% children attend school while 38.2% and 93% attend school in Clusters 2 and 3 respectively. Corroborating these attendance rates with the evidence on incidence rates of diarrhoea as discussed above leads to confirmation of a hypothesis that school going children from lower socioeconomic households, are exposed to greater risks of diarrhoeal diseases by consuming contaminated (most of them street) water, drinks, and food.  In Guatemala Koo (1996) had identified that ice based candies were prepared with unsafe water was highly contaminated and vibrios survived in these items. It is likely that similar routes of transmission may explain higher incidence of diarrhoea among school going children among poorer communities of Delhi.

 It is found that the incidence rates of diarrhoea in households which  do not use separate utensil to draw water from storage containers is higher than those which do so in Clusters 1 and 2. These results are as per theoretical expectations. However, in Cluster 3, the incidence rates are higher for home which use separate utensils. 

 

In Cluster 1, 11 water samples were collected from households that stored water from public hydrants. Of these 11 stored samples, 6 (55%) failed the test and 5 (45%) samples were found to be fit for human consumption. 8 water samples were collected from households in Cluster 2 that stored water from public hydrants. Of these 8 stored samples, 5 (62.5%) failed the test and 3 (37.5%) samples were found to be fit for human consumption. A unique feature of Cluster 3 was 100% storage, i.e. 100 households. Purposive sampling was done to apportion the remaining 16 samples among 19 hand pumps (source) and 99 households (rejecting 1 households where the source – the tube well had already been declared unfit). The samples were selected from each category in the ratio of 19:99. This worked out to 3 samples from hand pumps and 13 stored samples. 3 hand pumps were randomly selected from the 19 shallow hand pumps in question. All tested unfit for human consumption, with MPN values of 270 to 2400. Of the 13 stored samples, 1 was purposively selected from the household using tube well, which tested unfit. The other 12 were selected from households with individual MCD piped supply as hand pump sources were already found to be unfit. 10 (83%) stored MCD samples were fit while 2 (17%) were found to be unfit. 

 

DISCUSSION

For each age group, Cluster 3 had the lowest incidence rates compared to the other two clusters. Cluster 1 had the highest incidence of disease for all age groups and recall periods except the under-5 yrs. age group and adults (>18 years); the recall period being 2 weeks in both the cases. For all other categories the incidence rates of Cluster 2 were substantially lower than those of Cluster 1.

Though nearly all households reported accessing MCD water as the primary source of water in Cluster 1, about a tenth did not use it for drinking purposes. Compared to the other clusters, the use of handpumps was the lowest in Cluster 1. Despite these relative safety factors, the vulnerability of this cluster lay in the fact that water supply was intermittent. This forced all but one household (located next to a public hydrant), of those surveyed, to store MCD water.

 

Cluster 1 had lower per capita income at Rs.284.05 per head as compared to Rs. 345.71 in case of Cluster 2. The income distribution is skewed towards the lower end in Cluster 1 with 68% of the household earning not more than Rs. 1,500 per month. In as much as the level of the family income is an indicator of vulnerability, capturing the effects of factors not otherwise accounted for, (such as the ability to afford better alternatives in a situation of contamination or to adopt better preventive practices), family income levels showed that Cluster 1 was at a relative disadvantage as compared to the other two clusters, especially Cluster 3. 

 

 

 

 

 

 

Educational status of mothers in both these slum clusters was comparable with most of them (over 80%) being illiterate. The proportion of literates among heads of household is better for Cluster 1 than that of Cluster 2. Illiteracy among heads of household as well as illiteracy among mothers had a positive association with the consumption of hand pump water. A similar association had also emerged between family income levels and the consumption of hand pump water.

 

While both income levels and illiteracy emerged as vulnerability factors for Cluster 1, it is to be noted that the educational status in Cluster 2 could be a potentially important factor, indicating aspects of vulnerability such as awareness levels. This is further substantiated by evidence on school attendance by female children, with much higher numbers of female children in the five-plus age group, not attending school in Cluster 2. Combined with the total lack of sanitary latrines and the relatively higher reported usage of hand pump water as the primary means of accessing water for household purposes, the infrastructural problems combine with the educational status towards making this particular cluster vulnerable to the incidence of diarrhoeal disease. Cluster 3 reported the lowest incidence of illness for all age groups and recall periods. This also finds obvious correlation with the data on several socio-economic characteristics. The per capita income at Rs.879.49 per month was substantially higher. While the cluster also ranks best in terms of the educational status of the head of the household, the differences are marked in the case of the mothers’ educational levels with less than 10% of the mothers being illiterate as compared to over 80% in the other two clusters. With 100% households having access to sanitary latrines, Cluster 3 was at an advantage compared to the other 2 clusters in terms of the vulnerability indicators analyzed in this study.

 

It is to be noted that in Cluster 3, as many as 40% of the households reported use of hand pump water as a secondary source of water for household purposes. On the one hand, it is statistically not possible to establish a unidirectional causation between the incidence of illness and the extent of contamination arising from the mere use of a secondary source of water. However, it would be valid to hypothesize that where 19% of the households report direct consumption of water from hand pumps, and 40% report the usage of hand pump water as a secondary source to supplement the primary source, the cluster would become potentially vulnerable to diarrhoeal illness, although perhaps to a less extent than the other clusters where socio-economic factors would combine to make the situation more acute.

Amongst households storing MCD water (proven to be safe at source), adhering to the best storage practices does not translate into lower incidence rates as compared to those with relatively unsafe practices. As has been argued earlier a possible explanation for this lies in factors that are external to the home and largely beyond the control of the affected household members. Thus, household level behavioral factors such as storage practices cannot be  analyzed in isolation as determinants of diarrhoeal illness when pitted against stronger neighborhood and external determinants that are beyond the control of the individual household. The typical low-income migrant household faces these serious threats and are yet ‘targets’ for IEC campaigns of behavioral modifications when it comes to control of waterborne diseases when the sustainable solutions are infrastructural and not ‘behavioral’. 

 

Above research work is an outcome of the project  undertaken by Dr. Rajib DasGupta, Centre for Social Medicine & Community Health, JNU, New Delhi-110 067  

 

 

 

 

 

 

REFERENCES

 

Briscoe, J. 1984a Technology and child survival : the example of sanitary engineering. Population and Development Review. Vol. 10 (suppl.), pp: 237-253. 

 

Chakraborty, A. K. and Das, J. C. 1983. Comparative study of incidence of diarrhoea among children in two different environmental situations in Kolkata. Indian Paediatrics. Vol. 20(12), pp : 907-913.

 

Ghosh S., Sengupta, P. G., Mondal, S. K, Basu, M. K., Gupta, D. and Sircar, B K.1997. Risk behavioural practices of rural mothers as determinants of childhood diarrhoea. The Journal of Communicable Diseases. The Indian Society for Malaria and Other Communicable Diseases, Delhi. Vol. 29.

 

Glass R I, Svennerholm A M, Stoll B J, Khan M R, Hossain K M B, Haq M I and Holmgren J. 1983. Protection against cholera in breast-fed children by antibodies in breast milk. New England Journal of Medicine. Vol. 308 (23), pp : 1392-1398.

 

Koo, D. et al. 1996. Epidemic cholera in Guatemala, 1993 : transmission of a newly introduced epidemic strain by street vendors. Epidemiology and Infection. Cambridge University Press. Vol. 116, pp : 121-126.

 

Mehrotra Ritu Priya 1988. “The gastroenteritis outbreak and its control in Sunder Nagri : An assessment at community level.” Unpublished Report. Centre for Social Medicine and Community Health, Jawaharlal University, New Delhi.

 

Park, K. 2000. Park’s Textbook of Preventive and Social Medicine, 16th Edition. Banarasidas Bhanot Publishers, Jabalpur.

 

Vathanophas, K. et al. 1986. The study of socio-economic, behavioral and environmental factors related to diarrhoeal diseases in children under five years in congested area of Bangkok Metropolis. Journal of Medical Association of Thailand. Vol. 69, pp : 156-162.

 


 

INVITATION:

 

Population Environment Centre has been established at International Institute for Population Sciences, Mumbai by the Ministry of Environment and Forest, Government of India, in July 2004.  The core activities of this centre include: to bridge the knowledge gaps between the Population and Environmental Studies; to understand the interrelationship between population and environment at local, regional and global levels; to disseminate the knowledge on population and environment linkages and promote research in this area. The Population Environment Centre proposes to organize a National Seminar on “Population Environment and Nexus” on October 21, 2005.

 

THEMES OF THE SEMINAR

  • Interrelation between Population Environment and Development 

  • Urbanization and Environment,

  • Household Environment, Morbidity and Health

  • Environmental Issues in Health, Population Policy and Role of NGO’s

  • Gender, Environment and Access to Natural Resources.

CALL FOR PAPERS

 

The Population Environment Centre invites scientific papers from researchers, administrators, and planners working in the field of population environment.  Initially contributors are requested to submit an abstract of their research paper in about 200 words, not later than 3rd September 2005 preferably by e-mail or fax.  The abstract of the papers recommended by the review committee will be published and made available during the seminar.

 

To attend the seminar, contributors are requested to explore the financial resources existing at their end.  However arrangements for local hospitality for the seminar days would be made by the Population Environment Centre. Visit Website: http://www.populationenvis.org

 

IMPORTANT DATES

Submission of Abstracts: 3rd September 2005

Decision on the Abstracts: 8th September 2005
(By the organizing Committee)
Submission of Final Paper: 8th October 2005.